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ABSTRACT Background Methods Results Conclusions Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients.This case–control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US‐based data from the TriNetX global research network. TTM patients (ICD‐10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD‐10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive‐compulsive disorder, anxiety disorders, dissociative, stress‐related, and somatoform disorders, mood disorders, and suicide attempts compared to controls.TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841–2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2–3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826–2.765; p < 0.0001), obsessive‐compulsive disorder (OR: 11.047; 8.822–13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387–3.7; p < 0.0001), dissociative, stress‐related, and somatoform disorders (OR: 6.179; 3.935–9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288–2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121–2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event.Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

Alopecia areata is an autoimmune disorder characterised by sudden hair loss, and can range from patchy baldness to more severe forms such as alopecia totalis and universalis. Hair loss can have a profound impact on self‐esteem and body image, particularly during childhood and adolescence. Understanding the psychosocial impact of alopecia areata in paediatric and adolescent populations is crucial to address the emotional and social challenges faced by these patients. The aim is to review the existing literature for clinical studies and reports investigating the psychosocial impact of alopecia areata in paediatric and adolescent populations. A systematic review of the literature was performed using PubMed, Cochrane and Embase databases from inception to July 2023. Included articles assessed the psychosocial impact of alopecia areata in paediatric and adolescent populations. Of 79 total articles, 10 were identified as meeting the inclusion criteria. Several studies highlighted self‐esteem, emotional distress and social challenges as features of psychosocial manifestations. Factors such as stress, psychiatric comorbidities and familial issues are significantly associated with alopecia areata in these populations. The heterogeneity of studies precluded data synthesis and analysis. A majority of the included studies evaluated short‐term findings. Alopecia areata has significant psychosocial impacts in paediatric and adolescent populations, with studies emphasising the negative effects on self‐esteem, body image and quality of life. Additional research is required to better elucidate this relationship and draw meaningful conclusions to guide clinical support and interventions. [ABSTRACT FROM AUTHOR]

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Summary: Vitiligo is a common disorder characterized by the visible loss of skin pigmentation. Non‐segmental vitiligo (NSV) is the major subtype. The disease is caused by autoimmune‐mediated destruction of melanocytes. Vitiligo leads to stigmatization and a significant reduction in quality of life. Disregarding the psychosocial burden, vitiligo is sometimes viewed solely as a cosmetic problem and, according to a global survey, is diagnosed on average only after 2.4 years. This delay contributes to a considerable burden of disease, including suicidal ideation. Stigmatization promotes the development of psychological comorbidities such as anxiety and depressive disorders, with prevalence rates varying by country and study (0.1%–67.9%). Data for Germany are heterogeneous and largely based on estimates. Due to psychosocial factors, the inflammatory component, and a higher incidence of somatic comorbidities, NSV may be regarded as an inflammatory systemic disease. We recommend optimizing care by incorporating the assessment of quality of life as a standard in routine care, in addition to monitoring disease activity. Moreover, early screening for psychological comorbidities is crucial to initiate appropriate treatment before the condition becomes chronic and cumulative (irreversible) impairments occur. The goal is a personalized and patient‐centered integrated care approach that sustainably improves the health status of those affected. [ABSTRACT FROM AUTHOR]

Background: This report evaluates the potential of artificial intelligence (AI) in psychodermatology, emphasizing its ability to enhance diagnostic accuracy, treatment efficacy, and personalized care. Psychodermatology, which explores the connection between mental health and skin disorders, stands to benefit from AI's advanced data analysis and pattern recognition capabilities. Materials and methods: A literature search was conducted on PubMed and Google Scholar, spanning from 2004 to 2024, following PRISMA guidelines. Studies included demonstrated AI's effectiveness in predicting treatment outcomes for body dysmorphic disorder, identifying biomarkers in psoriasis and anxiety disorders, and refining therapeutic strategies. Results: The review identified several studies highlighting AI's role in improving treatment outcomes and diagnostic accuracy in psychodermatology. AI was effective in predicting outcomes for body dysmorphic disorder and identifying biomarkers related to psoriasis and anxiety disorders. However, challenges such as limited dermatologist knowledge, integration difficulties, and ethical concerns regarding patient privacy were noted. Conclusion: AI holds significant promise for advancing psychodermatology by improving diagnostic precision, treatment effectiveness, and personalized care. Nonetheless, realizing this potential requires large‐scale clinical validation, enhanced dataset diversity, and robust ethical frameworks. Future research should focus on these areas, with interdisciplinary collaboration essential for overcoming current challenges and optimizing patient care in psychodermatology. [ABSTRACT FROM AUTHOR]

Background: Vitiligo may impact psychosocial development, especially among African American pediatric patients, given heightened visibility and increasing rates of anxiety and depression in this subpopulation. Objective: Evaluate psychiatric comorbidities and treatment initiation in African American pediatric patients. Methods: A total of 327 African American pediatric patients with vitiligo were each matched to 3 patients without vitiligo by age, race, and sex in this case-control study. Prevalence of psychiatric conditions and subsequent initiation of pharmacotherapy and/or psychotherapy were analyzed. Results: Compared to controls, pediatric African American patients with vitiligo were significantly more likely to be diagnosed with depression (P

Abstract Chronic pruritus (CP) is defined as an unpleasant sensation causing a desire to scratch and lasting > 6 weeks. It has a multifactorial etiology but is more frequently associated with chronic inflammatory dermatoses and systemic disorders. Psychogenic pruritus and neurological disorders are other less common etiologies, while, in some patients, it is idiopathic. CP appears to be processed by non-histaminergic pathway, contributing to its complexity and therapeutic challenge. Moreover, regardless of the etiology, it is multidimensional, including cognitive, motivational and affective components. There is a close link between psychological distress and pruritus, with particular clinical expression in chronic inflammatory dermatoses, involving the activation of the hypothalamic-pituitary-adrenal axis (and its cutaneous equivalent), the sympathetic nervous system, the release of hormones and peptides, the role of immune cells (T and B cells, macrophages) and immune-related cells in the skin (mast cells, dendritic cells and keratinocytes). Moreover, there is strong evidence that psychological factors influence the experience of pruritus. CP can also cause psychiatric disorders, including but not limited to anxiety and depression, and also lead to significant quality of life (QoL) impairment. Thereby, although a psychodermatological assessment should ideally be carried out in the context of a specific psychodermatology consultation, a brief mental health assessment could be part of the general dermatological approach to these patients. Considering that mental health, QoL and pruritus are closely linked, psychotherapeutic interventions and/or psychotropic drugs should thus be considered in some patients as an adjunct to the pharmacological treatment of CP.

Stefanie Hölsken,1,&ast; Carina Benthin,2,3,&ast; Frederik Krefting,4 Senta Mühlhaus,1 Yvonne Nestoriuc,2,3 Manfred Schedlowski,1,5 Wiebke Sondermann4 1Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 2Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany; 3Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 4Department of Dermatology, Venereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 5Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden&ast;These authors contributed equally to this workCorrespondence: Wiebke Sondermann, Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, Essen, 45122, Germany, Tel +49201-723-3647, Fax +49201-723-5409, Email wiebke.sondermann@uk-essen.dePurpose: Psoriasis is a highly debilitating chronic inflammatory disease. Increased understanding of its pathophysiology has enabled development of targeted treatments such as biologics. Several medical treatments have been shown to be influenced by patients’ experiences and expectations. However, only little is known about patients’ experiences with and expectations towards biologics. Our objectives were to identify patients’ treatment experiences and treatment expectations and assess their trajectories over the course of treatment with the IL-17A inhibitor secukinumab. Moreover, we aimed to document effects of psoriasis, factors that influence symptomatology, and prior treatment experiences.Patients and Methods: We conducted semi-structured interviews with n = 24 patients with moderate-to-severe plaque psoriasis and employed a qualitative content analysis to derive thematic and evaluative codes. Findings were validated via peer debriefings with experienced dermatologists.Results: Patients reported burdensome physical and psychological psoriasis symptoms and identified factors that can improve or worsen symptomatology, including stress and self-efficacy. Prior treatment experiences were mostly negative. Past barriers to effective treatment included time constraints or limited access. Concerning secukinumab, patients initially expected complete to partial remission of symptoms and occurrence or absence of side effects. Closer inspection of expectations and experiences revealed three trajectories. For most patients, initial expectations were met and future expectations remained unchanged. For the other patients, however, the experience did not match their initial expectation. One group then adapted their future expectations according to their experience, while the other group did not.Conclusion: To our knowledge, this is the first qualitative study to assess expectations towards treatment effectiveness and side effects, their trajectories, and interplay with experiences among psoriasis patients. Our findings highlight the value of further research on the subject in order to optimize care for psoriasis patients and to learn more about the trajectories and influence of treatment expectations in general.Plain Language Summary: Patients’ expectations towards a certain treatment can influence how well it will work and whether side effects occur or not. Such effects have been shown for a wide range of conditions, including dermatological ones. For patients suffering from psoriasis, a chronic inflammatory skin disease, modern biologics offer promising treatment options. Therefore, modern biologics are likely associated with high expectations by patients. Yet, the roles of treatment expectations and the experiences of patients undergoing biologic treatment have only received little attention to date.With this qualitative study, we aimed to understand patients’ perspectives on these treatments, the symptoms they suffer from, expectations towards treatment effectiveness and side effects as well as treatment experiences in the past and over the course of treatment with a modern biologic. To this end, we conducted and transcribed interviews with 24 patients after several months of biologic treatment. We then analyzed interview transcripts to determine underlying categories and summarized these in a common framework.We found that patients’ debilitating physical and psychological symptoms were often not well controlled in past treatments. Still, patients had positive expectations with regard to biologic treatment. For a large group of patients, their actual experiences met their expectations, leaving them with unchanged expectations for the future. Another important finding was the good understanding of factors influencing their symptomatology that patients had, like stress and self-efficacy. The reported findings may aid doctors in their clinical work, to further improve care for psoriasis patients. Keywords: psychodermatology, patient perspective, treatment success, doctor-patient relationship, secukinumab

Chronic pruritus (CP) is defined as an unpleasant sensation causing a desire to scratch and lasting > 6 weeks. It has a multifactorial etiology but is more frequently associated with chronic inflammatory dermatoses and systemic disorders. Psychogenic pruritus and neurological disorders are other less common etiologies, while, in some patients, it is idiopathic. CP appears to be processed by non-histaminergic pathway, contributing to its complexity and therapeutic challenge. Moreover, regardless of the etiology, it is multidimensional, including cognitive, motivational and affective components. There is a close link between psychological distress and pruritus, with particular clinical expression in chronic inflammatory dermatoses, involving the activation of the hypothalamic-pituitary-adrenal axis (and its cutaneous equivalent), the sympathetic nervous system, the release of hormones and peptides, the role of immune cells (T and B cells, macrophages) and immune-related cells in the skin (mast cells, dendritic cells and keratinocytes). Moreover, there is strong evidence that psychological factors influence the experience of pruritus. CP can also cause psychiatric disorders, including but not limited to anxiety and depression, and also lead to significant quality of life (QoL) impairment. Thereby, although a psychodermatological assessment should ideally be carried out in the context of a specific psychodermatology consultation, a brief mental health assessment could be part of the general dermatological approach to these patients. Considering that mental health, QoL and pruritus are closely linked, psychotherapeutic interventions and/or psychotropic drugs should thus be considered in some patients as an adjunct to the pharmacological treatment of CP. [ABSTRACT FROM AUTHOR]

Hidradenitis Suppurativa (HS) is a chronic, Skin Immune-Mediated Inflammatory Disease (sIMID), with a high impact on Quality of Life (QoL). Data on clinical management, comorbidities, psychosocial burden, and psychiatric disorders in paediatric patients with HS is scarce. The aim of our study was to compare clinical characteristics and Patient-Reported Outcome Measures (PROMs) for Health-Related Quality of Life (HRQoL) in adult and paediatric patients with HS. Data were collected on 601 patients with HS, 60 of whom (10.0%) were paediatric. The psychological and HRQoL impact was generally higher in adults than in children, but it was noteworthy also in paediatric patients. Early diagnosis and interventions based on education for the patients and their families and psychological support are the key to optimal disease management and adherence. Our study underlines the need for screening for HS-associated psychiatric disorders and for using age-specific tools to evaluate HRQoL. A multidisciplinary approach involving several specialists is needed, as well as liaison with primary care specialists to improve care, and management of comorbidities and psychological issues in patients with HS.

Skin conditions carry a significant physical, psychological, and social burden. People with skin conditions often engage in health-threatening behaviours that can worsen symptoms and increase cardiovascular disease risk. However, access to dedicated psychological and behaviour-change support is limited. The impact, management, and existing psychological support available to adults living with skin conditions was qualitatively explored to inform the development of a psychologically supportive digital intervention. Qualitative research involving a hybrid inductive– deductive approach was performed. Data collection and analysis were theoretically informed by the Common-Sense Model of Self-Regulation. Eight synchronous online group interviews with 43 English-speaking adults (≥ 18 years) with a range of skin conditions were conducted. Data were analysed using Reflexive Thematic Analysis. Three superordinate themes are outlined: (i) visibility underpinning life course impairment, (ii) seeking control amid uncertainty, and (iii) existing support for people with skin conditions. Skin conditions carry a substantial psychological burden, yet dermatology service provision is sub-optimal and patients often resort to seeking support from unreliable sources. Psychological support can have benefits, but barriers exist. This study reinforces the need for high-quality psychological support, and that patients wanted digital means to support effective self- management.

Anhedonia, the reduced ability to experience pleasure, is a prevalent symptom in various psychiatric disorders, but has not been investigated in dermatological conditions, particularly those characterized by chronic itch. This study aimed to examine the prevalence and clinical correlates of anhedonia in patients with chronic itch. A cross-sectional study was conducted in 137 patients with chronic itch, classified according to the International Forum for the Study of Itch (IFSI) classification. Anhedonia was assessed using the Snaith–Hamilton Pleasure Scale (SHAPS) and Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Itch severity, quality of life, and psychological distress were assessed using the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), ItchyQoL, and Hospital Anxiety and Depression Scale (HADS), respectively. The mean SHAPS score was 1.0 ± 1.7 points, and the mean ACIPS total score was 76.9 ± 16.2 points. In the study sample, 13.1% of patients were identified as anhedonic, with a higher prevalence observed in those with severe and very severe itch. Anhedonia was significantly correlated with itch severity (R = 0.2, p=0.02 for 24 h VASmean and SHAPS; R = 0.2, p = 0.01 for 24 h VASmax and SHAPS), anxiety symptoms (R = 0.3, p

ObjectiveThe prevalence of anxiety and depression in patients diagnosed with Alopecia Areata (AA) is very high and this significant burden of psychological symptoms threatens the Health-Related Quality of Life (HRQoL) of affected patients. Indeed, AA often does not produce significant physical symptoms, but it nonetheless disrupts many areas of mental health. Clinical assessment of disease severity may not reliably predict patient's HRQoL, nor may it predict the patient's perception of illness. For this reason, considerable effort has been made to apply and develop measures that consider patient's perception and assess the HRQoL of individuals affected by AA. The aim of this multicentric study was to provide the Italian version of the Skindex-16AA and to evaluate its psychometric properties in a clinical sample of consecutive patients with moderate-to-severe AA.MethodsThis is a longitudinal, multicenter, observational study. Patients returned for follow-up visits at 4-, 12-, and 24-weeks. The analyses of the current work aimed to confirm the factorial structure of the Skindex-16AA. In the case of non-fit, an alternative structure for the model was proposed, using an Exploratory Graph Analysis and the Bayesian approach.ResultsThe sample was composed of 106 patients with AA. Alopecia Universalis was the most frequently diagnosed type of alopecia at all time points. The analyses on the Skindex-16AA revealed that a two-factor structure with eight items fit the data best (Bayesian Posterior Predictive Checking using 95% Confidence Interval for the Difference Between the Observed and the Replicated Chi-Square values = −6.246/56.395, Posterior Predictive P-value = 0.06), and reported satisfactory psychometric properties (i.e., internal consistency and convergent validity).ConclusionThe Skindex-8AA demonstrated optimal psychometric properties (i.e., convergent and construct validity, and test-retest reliability) measured in a sample of patients with AA, that may suggest that it is an appropriate tool to measure the HRQoL in AA patients. However, further studies are needed in order to confirm and tested other psychometric features of this tool.

Abstract Background Cosmetic Rhinoplasty is one of the most common facial plastic surgeries. Recognition of patients with psychological problems may affect the outcome of surgery. Carefully chosen cases may improve the patients’ well-being. Objective To analyze the existing literature for clinical studies and investigate the psychological implications and Quality of Life after Cosmetic rhinoplasty. Methods A comprehensive review of the literature was performed using PubMed, Google Scholar, Mendeley and FindIt@MSP were searched between 2008 and 2023 in English text only. Included articles assessed the comparison between preoperative and postoperative psychological outcomes of cosmetic rhinoplasty as well as impact on QOL. Results Of the 53 articles selected for screening, 16 were identified as meeting the inclusion criteria. Based on the literature, surgical intervention appears to have a positive effect on various psychological factors such as self-esteem, body image, depression, and anxiety. Additionally, evidence suggests significant improvements in QOL, mental health, social function, and postoperative satisfaction, accompanied by a reduction in psycho-social distress. Limitations Factors such as monetary incentives for participation, lack of blinding, and self-reported measures within studies decrease the validity of results. Additionally, in some of the studies examined, there was an inability to isolate rhinoplasty procedures performed solely for cosmetic concerns. Conclusions Cosmetic rhinoplasty has been long regarded as a transformative intervention with beneficial effects on self-esteem, body image, and mental well-being, encompassing reductions in depression and anxiety. The present study highlights the substantial improvements in QOL and social functioning post-rhinoplasty, accompanied by heightened overall satisfaction with appearance and diminished levels of psycho-social distress. These findings contribute valuable insights into the broader implications of cosmetic rhinoplasty beyond physical changes, emphasizing its potential for positively influencing psychological and emotional well-being.

Marta Szepietowska, Aleksandra A Stefaniak, Piotr K Krajewski, &Lstrok;ukasz Matusiak Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Piotr K Krajewski, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, Wroclaw, 50-368, Poland, Email piotr.krajewski@umw.edu.plBackground: Anhedonia is defined as a reduced ability to experience or even a total loss of pleasure.Purpose: This study was undertaken to evaluate anhedonia in 104 consecutive acne patients.Material and Methods: Acne severity was assessed with Investigator Global Assessment (IGA), anhedonia was studied with the Snaith-Hamilton Pleasure Scale (SHAPS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) and Temporal Experience of Pleasure Scale (TEPS). Moreover, the quality of life (QoL) and stigmatization, as well as depression and anxiety (Hospital Anxiety and Depression Scale – HADS), were additionally evaluated.Results: Anhedonia was found in 20.19% of acne patients and was more common (p=0.007) in males (34.29%) than in females (13.04%). Based on SHAPS, males with acne showed significantly (p=0.049) higher levels of anhedonia (2.39 ± 3.18 points) than acne females (1.26 ± 2.36 points). Anhedonia significantly correlated with the clinical acne severity (SHAPS: r=0.205, p=0.038 and ACIPS: r=− 0.222, p=0.026). Although the intensity of anhedonia did not show any relationship with QoL and stigmatization assessments, there was a significant correlation between anhedonia and depressive symptoms (SHAPS: r=0.310, p< 0.001; ACIPS: r=− 0.364, p< 0.001). Such dependency was not documented for anxiety.Conclusion: Anhedonia seems to be a common phenomenon in acne and should be considered in the holistic approach to acne patients.Keywords: acne, anhedonia, depression, psychodermatology

Background: Cosmetic Rhinoplasty is one of the most common facial plastic surgeries. Recognition of patients with psychological problems may affect the outcome of surgery. Carefully chosen cases may improve the patients' well-being. Objective: To analyze the existing literature for clinical studies and investigate the psychological implications and Quality of Life after Cosmetic rhinoplasty. Methods: A comprehensive review of the literature was performed using PubMed, Google Scholar, Mendeley and FindIt@MSP were searched between 2008 and 2023 in English text only. Included articles assessed the comparison between preoperative and postoperative psychological outcomes of cosmetic rhinoplasty as well as impact on QOL. Results: Of the 53 articles selected for screening, 16 were identified as meeting the inclusion criteria. Based on the literature, surgical intervention appears to have a positive effect on various psychological factors such as self-esteem, body image, depression, and anxiety. Additionally, evidence suggests significant improvements in QOL, mental health, social function, and postoperative satisfaction, accompanied by a reduction in psycho-social distress. Limitations: Factors such as monetary incentives for participation, lack of blinding, and self-reported measures within studies decrease the validity of results. Additionally, in some of the studies examined, there was an inability to isolate rhinoplasty procedures performed solely for cosmetic concerns. Conclusions: Cosmetic rhinoplasty has been long regarded as a transformative intervention with beneficial effects on self-esteem, body image, and mental well-being, encompassing reductions in depression and anxiety. The present study highlights the substantial improvements in QOL and social functioning post-rhinoplasty, accompanied by heightened overall satisfaction with appearance and diminished levels of psycho-social distress. These findings contribute valuable insights into the broader implications of cosmetic rhinoplasty beyond physical changes, emphasizing its potential for positively influencing psychological and emotional well-being. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This report delineates two instances of dermatitis artefacta (DA), a psychodermatological condition marked by self‐induced or exacerbated skin lesions. These cases, triggered by treatments from non‐qualified practitioners, highlight the critical need for healthcare professionals to discern the potential repercussions of unsound medical guidance. [ABSTRACT FROM AUTHOR]

Diseases of the skin and its appendages currently occupy one of the leading places in terms of prevalence. In addition, today the relationship between dermatopathologies and the psychoemotional state of people and vice versa is clearly monitored. Psychodermatology is engaged in the study of exactly this regularity. One of the most common trichological diseases is androgenic alopecia, which is characterized by excessive hair loss under the influence of androgens in individuals with a hereditary predisposition. Androgenic alopecia is often accompanied by secondary mental disorders, which significantly impair the quality of people's life. It is relevant to conduct sociological research of this problem among men of all age groups. Such research will reveal the level of influence of androgenic alopecia on the psychoemotional state of men who may be potential consumers of medicines and dermatocosmetics. The aim of the work was to conduct a sociological study to establish the impact of androgenic alopecia on the psychoemotional state of men and their readiness for pharmacotherapy. Materials and methods. Sociological research was conducted from 01.03.2019 to 31.08.2019 by surveying 150 men aged 18 to 66. Respondents were visitors to pharmacies in the Ivano-Frankivsk and Chernivtsi regions of Ukraine, who gave written consent to participate in the survey. Only persons with visible manifestations of androgenic alopecia according to the Norwood scale were included in the survey. All respondents were divided into the following age groups: from 18 to 20 years old, from 21 to 30 years old, from 31 to 40 years old, from 41 to 50 years old, from 51 to 60 years old, from 61 years old and older. The distribution was carried out to segment the target market. The results of the study were displayed as percentages with 95 % confidence intervals. Statistical analysis was performed using R version 4.1.2 (R Core Team (2021). The results. According to the results of the sociological study, 48.7 % of interviewed men consider that androgenic alopecia is a problem which can affect the emotional state and, so, the quality of life. As a result, about 90 % of the respondents indicated that they need to expand the assortment of effective remedies to solve this problem on the pharmaceutical market of Ukraine, of which 36.7 % are ready to pay for a course of effective pharmacotherapy from 200 to 500 hryvnias. Conclusions. The obtained results confirm that androgenic alopecia has a negative effect on the psychoemotional state of men and worsens their quality of life. To solve the problem of androgenic alopecia, men are interested in using effective medicinal or dermatocosmetic products [ABSTRACT FROM AUTHOR]

A study published in the International Journal of Dermatology examined the relationship between mental health and skin cancers such as basal cell carcinoma, squamous cell carcinoma, and melanoma. The study used data from the All of Us Research Program, which aims to include underrepresented groups in medical research. The findings showed that all skin cancers were associated with higher odds of developing psychiatric comorbidities, with melanoma patients having the highest odds of anxiety and depression, and squamous cell carcinoma patients having the highest odds of insomnia. The study suggests that healthcare providers should prioritize the mental well-being of patients with skin cancer, but further research is needed to fully understand this relationship. [Extracted from the article]

Ointment pseudo‐cheilitis is a recently recognized distinctive type of self‐induced cheilitis. Lesions consist of a variable amount of crusts adhered to the vermilion. These crusts consist of dried saliva and dead cells mixed with applied medications attached to the lip surface. Patients are typically severely anxious or depressed; the condition impacts quality of life. Ointment pseudo‐cheilitis is frequently misdiagnosed as exfoliative cheilitis or cheilitis glandularis. Biopsy reports are often non‐revealing because there are no established histopathological criteria for this disease, and clinicians usually do not formulate the correct diagnostic hypothesis. Here, we present the histopathological findings of four cases of ointment pseudo‐cheilitis. The most consistent finding was the presence of laminated parakeratotic material detached from the epithelium in biopsies that are devoid of other significant diagnostic changes. This material at the lip surface possibly represents physiologic labial desquamation mixed with dried saliva and applied medication. With this report, we intend to alert dermatopathologists to the diagnosis of ointment pseudo‐cheilitis if they receive biopsies from patients who present clinically exuberant labial lesions that show only minimal histopathological changes. [ABSTRACT FROM AUTHOR]

Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) shares similarities with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) regarding pathogenesis involving neuroinflammation and genetics. Nevertheless, evidence on the associations of AD with ADHD and/or ASD is inconclusive. This study aimed to systematically examine the existing evidence on the associations between AD, ADHD, and ASD. Methods: The Meta-Analysis of Observational Studies in Epidemiology guideline was followed. We searched MEDLINE, Embase, Cochrane Library, and Web of Science databases from their respective inceptions to March 4, 2022. Observational studies providing adjusted estimates and/or prevalences for ADHD and ASD in patients with AD were enrolled. A random-effects model meta-analysis was conducted to calculate pooled odds ratios (ORs) and confidence intervals (CIs). Subgroup analyses according to AD severity, age, geographic location, and study design were performed. Results: Overall, a total of 24 studies with 71,373,639 subjects were enrolled. Our meta-analysis demonstrated significant associations of AD with ADHD (pooled OR: 1.28; 95% CI: 1.18–1.40) and ASD (pooled OR: 1.87; 95% CI: 1.30–2.68). Subgroup analyses revealed that the associations for ADHD were the most prominent in studies evaluating severe AD patients as well as in studies focusing on school-age children and adolescents. Among patients with AD, the pooled prevalence of ADHD was 6.6%, and the respective prevalence of ASD was 1.6%. Conclusion: The evidence to date suggests significant associations of AD with ADHD and ASD. Psychiatric consultation and an interdisciplinary approach would benefit patients with AD presented with behavioral symptoms suggestive of ADHD or ASD. [ABSTRACT FROM AUTHOR]

Lichen planus is an immune-mediated idiopathic inflammatory dermatosis with a prevalence that remains high among middle-aged adults. The typical lesions are represented by purple, pruritic papules located on the extremities, trunk and genital region. Several exogenous agents have been implicated in the etiology of the condition, among which we can list viruses, drugs and contact allergens. Although the role of psychological factors in the occurrence of lichen planus has not been fully demonstrated, stress has an important impact in the initiation and especially in the maintenance of the disease. Along with drug treatment, stress management with the help of psychotherapy and a multidisciplinary collaboration between the dermatologist and the psychiatrist would be of real help for patients with severe forms of the disease. Research in the field of psychodermatology is currently a subject of real interest, considering the increasingly frequent association between skin conditions and some psychoemotional dysfunctions such as stress, anxiety, depression. [ABSTRACT FROM AUTHOR]

Delusional infestation (DI) is a psychiatric disorder defined by the fixed, false belief that one has been infested by an organism without evidence to support this. Patients may present with skin lesions and report abnormal cutaneous sensations. The diagnostic workup for patients presenting with delusional infestation is essential to ensuring accurate diagnosis in ruling out other explanations for symptoms and investigating potential secondary causes of DI. In addition to a comprehensive history and physical examination, laboratory workup should be considered depending on the clinical picture. Antipsychotic medications are the most common drugs used in management of adults with DI and tailor the choice of treatment according to patient characteristics. This article serves as a guide for dermatologists, psychiatrists, and other clinicians as it reviews the workup and screening that should be considered when managing a patient with delusional infestation and subsequent treatment protocols once the diagnosis has been made. [ABSTRACT FROM AUTHOR]

Psychodermatology pertains to the relationship between the skin and brain. This review aims to summarize the evidence of the mind body connection in four psychophysiological conditions: rosacea, atopic dermatitis (AD), acne vulgaris (AV), and psoriasis. A literature search was conducted using several English language databases. All four conditions share similar psychiatric co-morbidities, including but not limited to anxiety, depression, and suicidality. In rosacea, the upregulation of transient receptor potential vanilloid type 1, Toll like receptor 2, and Th17 cells releases downstream products that are simultaneously implicated in mood disorders. Stress exacerbates AV through the hypothalamic-pituitary-adrenal (HPA) system, which alters functioning of sebocytes and Cutibacterium acnes. In AD and psoriasis, the HPA axis influences Th1, Th2, Th22, and Th1, Th17 immune mediated responses, respectively. This leads to the secretion of pro-inflammatory cytokines which are also involved in the pathogenesis of anxiety and depression. Neurotransmitters implicated in mental illness, such as gamma-aminobutyric acid and serotonin, may also play a role in the development of AD and psoriasis. The management of cutaneous disease may mitigate psychological distress, and future research may show the corollary to also be true. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a systemic inflammatory disease with an immunological basis. The estimated number of people suffering from psoriasis is 60 million. Despite the large number of patients with this diagnosis, the question of which mechanisms are mainly responsible for its development has not yet been answered. One theory is that a change in the patient's psychological state acts as a trigger for the manifestation and worsening of the disease. Another unresolved issue is the relationship between sports and psoriasis. While some studies suggest exercise might worsen symptoms, others highlight potential benefits like improved quality of life. Aim of the study : The aim of our study is to present connection between mental state of patients and occurance of psoriasis. Additionally, the study aims to elucidate the potential benefits of integrating psychological interventions and physical activity into psoriasis management strategies, with the goal of improving patient outcomes and enhancing overall quality of life. Material and methods : We searched electronic databases, using keywords such as „Psoriasis”, „Depression” and „Psoriasis and sport ”. Conclusions : Psoriasis stands as a profound example of the intricate interplay between physical health and mental well-being. The findings presented in this paper underscore the importance of a holistic approach to psoriasis management, integrating dermatological, psychological, and physical interventions.

Mindfulness is a special type of attention, namely focusing on the current moment in a non-judgmental manner. Extensive mindfulness-based interventions have been shown to have positive effects in patients with psoriasis. However, it is unclear whether brief (2-week) interventions are also beneficial. Therefore, the aim of this study was to investigate the effects of a 2-week mindfulness-based intervention in patients with psoriasis. Patients were randomly assigned to an experimental (treatment-as-usual + mindfulness-based intervention) or control group (treatment-as-usual) during their clinic stay. All variables were measured by self-report using validated questionnaires: primary outcomes were mindfulness and self-compassion, secondary outcomes were itch catastrophizing, social anxiety, stress and skin status. Variables were assessed prior to, immediately and 3 months after the intervention. Effects were tested by repeated-measures analysis of variance (ANOVA). Analyses of pre-post-measurements (n = 39) revealed a significant interaction effect on self-reported mindfulness [F(1,35) = 7.46, p = 0.010, η2p = 0.18] and a tendency to a significant effect on self-reported self-compassion [F(1,36) = 3.03, p = 0.090, η2p = 0.08]. There were no other significant effects, but most descriptive data were in favour of the experimental group. However, the control group showed a greater improvement in skin status. Further studies are needed to replicate these findings and investigate which subgroups especially profit from such an intervention.

Key Clinical Message This report delineates two instances of dermatitis artefacta (DA), a psychodermatological condition marked by self‐induced or exacerbated skin lesions. These cases, triggered by treatments from non‐qualified practitioners, highlight the critical need for healthcare professionals to discern the potential repercussions of unsound medical guidance.

Abstract Delusional infestation (DI) is a psychiatric disorder defined by the fixed, false belief that one has been infested by an organism without evidence to support this. Patients may present with skin lesions and report abnormal cutaneous sensations. The diagnostic workup for patients presenting with delusional infestation is essential to ensuring accurate diagnosis in ruling out other explanations for symptoms and investigating potential secondary causes of DI. In addition to a comprehensive history and physical examination, laboratory workup should be considered depending on the clinical picture. Antipsychotic medications are the most common drugs used in management of adults with DI and tailor the choice of treatment according to patient characteristics. This article serves as a guide for dermatologists, psychiatrists, and other clinicians as it reviews the workup and screening that should be considered when managing a patient with delusional infestation and subsequent treatment protocols once the diagnosis has been made.

Delusions of parasitosis (DOP), which is also called Morgellons disease or delusional infestation, can be one of the most challenging clinical encounters in a dermatologist's practice. One reason for this is lack of education during dermatology residency and a paucity of resources for the practicing dermatologist such as specialized psychodermatology clinics for these patients. To help close this knowledge gap, an interview was conducted with 3 experts in the field of psychodermatology and their responses were recorded and edited with goal of improving care for patients suffering from DOP by educating the busy, practicing dermatologist. The experts discussed many topics regarding DOP including the difference between primary and secondary DOP, how to build a good rapport with DOP patients, why the condition is seen mostly in older woman, and which medications are effective for treatment. The interview ends with a few high-yield practical treatment tips.

Background: Patients with psychiatric dermatoses may be high users of healthcare, especially emergency services. A dermatology urgent care model may reduce healthcare utilization in this population. Objective: To determine whether a dermatology urgent care model can reduce healthcare utilization among patients with psychiatric dermatoses. Methods: We conducted a retrospective chart review of patients seen in dermatology urgent care at Oregon Health and Science University between 2018 and 2020 with diagnoses of Morgellons disease and neurotic excoriations. Rates of diagnosis-related healthcare visits and emergency department visits were annualized before and during engagement with the dermatology department. Rates were compared using paired t-tests. Results: We found an 88.0% reduction in annual rates of healthcare visits (P

Waritsara Piyanonpong, Poonkiat Suchonwanit Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Poonkiat Suchonwanit, Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand, Tel +66-2-2011141, Fax +66-2-201-1211 Ext 4, Email poonkiat@hotmail.comAbstract: Plica neuropathica (PN), also known as plica polonica, trichoma, matting, felting, or bird’s nest hair, is a common but rarely reported hair disorder. It is characterized by the abrupt onset of irreversible hair entanglement, forming a densely matted hair mass. PN has been associated with the use of ionic or herbal shampoos, vigorous hair care practice, self-neglect, systemic infection, parasitic infestation, immunosuppressive drugs, and psychiatric conditions. However, literature supporting the coexistence of PN in psychiatric disorders is scarce. PN may be one of the presenting symptoms observed by physicians. In some cases of psychiatric illness, patients consult more readily with non-mental health professionals than psychologists or psychiatrists. To highlight this issue, we herein report a case of PN in a 32-year-old woman with a 1-month history of being unable to detangle her hair. The patient initially visited the dermatology department and was subsequently diagnosed with schizophrenia following psychiatric consultation. After establishing the fundamental diagnosis apparently underlying the PN, psychiatric treatment with antipsychotic medication and dermatological treatment of the hair condition were instituted. There was an improvement in both at the four-week follow-up. This case history highlights a rare presentation of schizophrenia.Keywords: electrostatic force, hair care, matted hair, psychodermatology, self-neglect, trichology

Hand eczema is one of the most frequent dermatological diseases, with an incidence increased during the COVID-19 pandemic. The impact on life quality is considerable, giving rise to the need for a psycho-dermatological approach. This is a Randomized Control Trial (RCT) evaluating, either by the dermatological or psychological point of view, the effectiveness of an emollient and rehydrating topical product (Rilastil Difesa Sterile® cream) versus a standard treatment (i.e. moisturizing basic cream) in a group of 51 healthcare workers suffering from hand eczema during the COVID-19 pandemic. The enrolled subjects were randomized into a treatment or a control arm, treated for 8 weeks, and monitored through a clinical score (HECSI) and questionnaires evaluating the impact of the pathology and treatment on quality of life (DLQI and QOLHEQ). A psychometric evaluation was performed using the SCL-90 R, OCI-R, and CPDI scales. Our data, despite not reaching the statistical significance, demonstrated that both the clinical and psychological scores decreased mostly in patients treated with Rilastil Difesa Sterile® cream when compared to those treated with simple topical emollients. Moreover, we observed a high level of psychic suffering in dermatological patients and a parallel change in dermatological and psychological indicators, thus confirming their connection.

Purpose: to substantiate the algorithm for predicting the state of psychological adaptation - maladaptation of patients with dermatological pathology with different levels of vital threat, on the basis of which to develop personalized psychocorrection programs for this contingent, and to evaluate the effectiveness of their implementation. . Contingent and research methods. Based on the principles of biomedical ethics and deontology, we comprehensively examined 120 dermatological patients who were treated in three branches of the clinic "Dr. Zapolska Clinic" during 2020-2022, namely: 60 patients with non-vital dermatological diseases (seborrheic keratosis L82, condylomas A63.0, angiomas D18.0, pigmentation disorders L80), and 60 patients with dermatological diseases posing a vital threat ( melanoma C43, basal cell carcinoma C44, skin carcinoma in situ D04). Results. Among patients with dermatological diseases, there are both psychologically adapted and maladapted individuals, regardless of the vitality/non-vitality of the pathological process. The process of formation of psychological maladaptation in patients with dermatological diseases with different levels of vital threat does not have nosospecificity, but depends on the initial state of the adaptive resource base of the individual, first of all, its psychosocial and individual-psychological components. Summarizing the obtained results made it possible to identify three main blocks of characteristics that cover a wide range of biological, individual-psychological, social-environmental and psychosocial factors, which we defined as factors/markers of psychological adaptation-maladaptation in patients with dermatological diseases with different levels of vital threat: psychoemotional , psychosocial and personal. Based on the analysis of determined markers of psychological adaptation-maladaptation using mathematical methods, an algorithm for assessing and predicting psychological maladaptation in this contingent of patients is proposed. This algorithm determines the criteria of personification, the structure and scope of developed psychocorrective measures at different degrees of risk of psychological maladaptation in patients with dermatological diseases with different levels of vital threat. A three-stage system of psychocorrective interventions (assessment-diagnostic, clinical-therapeutic, and correction-adaptation stages) has been developed, united by the complexity and continuity of correction, psychotherapeutic, and adaptation measures. At the assessment-diagnostic stage, the prognosis of the development and progression of maladaptation is assessed, which ensures the personification of psychocorrective interventions, which are carried out mainly at the clinical-therapeutic stage, the positive effect of which is fixed at the last, corrective-adaptation stage. The evaluation of the effectiveness of these measures proved their effectiveness in eliminating psychopathological manifestations (depression and anxiety), improving the quality of life and social functioning, and increasing vitality and resilience. Conclusion. Personalized psychocorrection of patients of dermatological practice with different levels of psychological maladaptation may be recommended for the introduction into health care practice.

The aim of the study was to analyze the level of stigmatization among patients with plaque psoriasis according to their demographic and clinical characteristics. The study included 122 patients who completed the 6-item and 33-item Feelings of Stigmatization Questionnaire and a sociodemographic survey. The analysis of the 6-item Stigmatization Scale showed a mean stigmatization score of 6.4 points. (Me = 6; s = 3.7); the mean score for the 33-item scale was 81.3 points (Me = 79.5; s = 19.9). Female patients felt stigmatized more often than males. Respondents living in the countryside had a stronger sense of stigmatization in the Sensitivity to Others' Attitudes (p = 0.0238) and Secretiveness (p = 0.0234) domains. The presence of psoriatic lesions across the entire body was the only explanatory variable significantly determining the level of stigmatization in the Positive Attitudes domain, either through the main effect or through the interaction with the patient sex. A highly significant difference was found for the feeling of being flawed domain (p = 0.044), with a mean score of 13.4 points. The issue of stigmatization in psoriasis deserves more attention, as the analysis of this problem may provide a better insight into the effect of the disease on the patient's condition, not merely in the context of its clinical manifestation. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the knowledge, awareness, and practice patterns of Lithuanian dermatovenereologists regarding psychocutaneous medicine. An online survey questionnaire was distributed to the members of the Lithuanian Association of Dermatovenereologists and to dermatovenereologists through public and private healthcare institutions in Lithuania. The questionnaire consisted of questions related to dermatovenereologists' awareness, knowledge, experience, and training needs regarding psychocutaneous disorders. 50% of respondents reported having a good or excellent understanding and knowledge of psychodermatology, and 42% feel prepared to consult psychodermatology patients. 54% of doctors rated their preparedness to prescribe psychopharmacological treatment as poor. The most frequent diagnoses referred to mental health professionals were dermatitis artefacta, acne excoriée, other self-inflicted dermatoses, trichotillomania, and pruritus. The most common course of action with patients at high risk of suicide or other acute psychiatric condition was trying to provide psychological support during dermatovenereology consultation. The most frequent management tactic for patients with chronic psychological problems was a referral to a psychiatrist. 85% of all respondents would participate in educational events about psychodermatology. 70% expressed interest in events about psychopharmacological treatment in dermatology. Lithuanian dermatovenereologists have a good understanding and knowledge of psychodermatology and are willing to further their education in this field. However, some gaps remain. Many doctors reported feeling poorly prepared to administer psychopharmacological treatment to their patients and there seems to be a lack of formal training in psychodermatology in Lithuania. [ABSTRACT FROM AUTHOR]

Research has confirmed that psychosocial factors (such as burdensome distress) can play a significant role in deterioration of patient's quality of life, the recurrence and persistence of skin conditions in dermatological patients, as well as affecting adherence. According to the literature, the skin conditions that have the greatest impact on quality of life are psoriasis, contact dermatitis, atopic dermatitis, urticaria, alopecia, leprosy or Hansen's disease, scars, hyperhidrosis and genital human papillomavirus. Despite this, dermatological care in the current Hungarian dermatological practice is mainly focused on biomedical treatments. The interdisciplinary, complex assessment of psychosocial factors and referral to psychosocial care (by this is meant the ward psychologist, psychiatrist or district psychiatric nurse or other psychotherapeutic or support centre) is often incidental and is not systematic. The multidisciplinary approach and treatment proposed in the literature is limited and only available in a few priority centers. We consider it important to present the literature that argues in favor of complex care and to outline the proposed treatment models. The introduction of psychodermatology combined clinics could be a cost-reducing solution for treating dermatological diseases and comorbid psychological and psychiatric disorders, as it reduces the number of inaccurate diagnoses, the rate of ineffective treatments, and the number of unnecessary referrals. In this study, the authors suggest a rapid mental status assessment that can be used during the first doctor-patient encounter and how it can be used to complement the clinical history of psychocutaneous patients. They propose a psychological screening package for dermatological disorders and conclude the paper by arguing for support groups and psychotherapeutic individual, group and online self-help interventions that are effective. [ABSTRACT FROM AUTHOR]

Skin diseases have been identified as the fourth biggest burden of non-fatal public health problems worldwide, posing a major challenge to both those affected and the healthcare system. Psychosocial factors, stressful life events and stress often play a major role in the development and course of these diseases, with sufferers often experiencing a poor quality of life and a high prevalence of comorbid psychosocial disorders. Recently, there has been a growing body of literature arguing for the standardisation of psychodermatological classification in order to improve clinical practice, to better understand people with these conditions and to develop a common conceptual framework for the different professions (dermatologists, general practitioners, psychiatrists, psychologists). These studies classify psychodermatological disorders into four main groups and further subgroups. In this article, we present the proposals for the new classification system and the interdisciplinary approach of psychodermatology or psychocutaneous medicine, which aims to pay attention to the biological, psychological and social components of dermatological diseases. In clinical practice, in the absence of a psychodermatological approach and interdisciplinary -- i.e. complex -- treatment, we often observe stagnation or deterioration in the condition of the population concerned. However, the literature suggests that by integrating psychosocial factors of the psychodermatological approach, such as psycho-social assessment, and psychosocial treatments to complement conventional treatment, the condition of people with dermatological diseases can be improved. Based on a literature review of guidelines for improving the care of patients with skin disorders, we recommend psychodermatology education for health care staff and professionals and the creation of conditions for complex care. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy has been a contentious issue even before the pandemic. The COVID-19 crisis has further amplified vaccine hesitancy, with worries about adverse effects, cultural and religious beliefs, and misinformation on social media. In dermatology, patients with pre-existing skin conditions may have specific concerns about the impact of the vaccine on their skin health. Factors such as cutaneous reactions, potential flares of underlying conditions, and fears of psoriasis worsening post-vaccination contribute to vaccine hesitancy. Healthcare professionals, including dermatologists, play a crucial role in addressing vaccine hesitancy by providing accurate information, addressing concerns, and understanding the psychological impact on patients. The concept of vaccine fatigue is also explored, noting the challenges in sustaining vaccine acceptance over time, especially with regards to booster vaccinations. Overcoming vaccine hesitancy requires trust-building, effective communication strategies, and collaboration between healthcare workers and non-healthcare individuals to combat misinformation. By recognizing and addressing psychological factors, dermatologists can increase vaccine acceptance and improve public health efforts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Psoriasis is a multisystem chronic inflammatory skin disease and is a relatively common disorder in children and adults. The burden of psoriasis impacts both the physiological and psychological areas of ones life. Given the robust use of the internet and social media, patients have turned to Instagram for educational and social support to discuss psoriasis. OBJECTIVE: This study aimed to characterize how patients interact with Instagram to cope with the biopsychosocial aspects of psoriasis. We analyzed journals and organizations, and compared them with the public profiles of individuals diagnosed with psoriasis who provided information and refuge. Our goal was to identify how followers engaged and what type of content they were most receptive to in terms of psoriasis. METHODS: All journals and organizations representing psoriasis were selected for review. The top 10 public profiles of individuals diagnosed with psoriasis were also selected for comparison. The numbers of followers, followings, and posts were noted to evaluate popularity. The numbers of likes and comments were also recorded to understand engagement. RESULTS: On comparing journals and organizations to public profiles, we found that the former had a greater number of followers but engaged less with the audience on Instagram based on the number of profiles they followed. Profiles of individuals with psoriasis produced content that was more personal and relatable, including experiences with flares, motivational text, and emotional support. The content produced by journals and organizations was geared toward education and providing peer-reviewed resources and commentary from licensed health care professionals. Followers were more engaged via likes than comments on the Instagram profiles of journals and organizations, as well as the public profiles of individuals diagnosed with psoriasis. CONCLUSIONS: There was evident online presence of journals and organizations, and public profiles of individuals providing content regarding psoriasis on Instagram. However, there were distinguishing features for the type of content being produced. Journals and organizations took the traditional approach in providing evidence-based information, whereas the public profiles of individuals provided content related to the psychosocial needs of the psoriasis community. The 10 profiles of individuals provided posts involving creativity and real experiences, which were evidently well-received based on likes and comments. This research helps us appreciate what the audience on Instagram is looking for to further address how we can merge these needs to provide a holistic platform on Instagram for both providers and patients. Social media creates a space for collaboration, which can be advantageous for journals and organizations to work with patient volunteers from diverse backgrounds who can help build a therapeutic alliance and public presence on Instagram with their viewers in order to deliver medical peer-reviewed information.

The fields of dermatology and psychiatry have overlap in the patient populations and diseases they treat. However, there are not currently fellowship opportunities for dermatologists or psychiatrists specifically interested in gaining expertise in psychodermatology. We discuss the logistics of a one-year psychodermatology fellowship, open to residents after completing either dermatology or psychiatry residencies, and the potential benefits that it could bring to both dermatology and psychiatry training programs across the county.